:D Hi Pat. Thanks for asking Dr De Smet. It gives us confidence that women and smaller men can always have a resurfacing some where in the world and get help. Mine is in the middle. 48mm. Dr De Smet has been doing this along time as you have indicated the report is back in 2008 and not much has changed since then with his findings. I am not going to get into the issue of the BHR to any other device except do your own home work and be happy with your decision. If it works well enjoy your new hips.
This site helps us do that talk about "stuff".
Correct me if I am wrong as well in Europe and may be other counties you get a 2 mm increase in size. In the US I think it is 4mm increment unless this has changed for the BHR. Cheers K